Uganda Healthcare: TMCGs’ virtual doctors role

Uganda healthcare: There is only one doctor for every 25,000 people and mobile technology has emerged as a lifeline for citizens who now have established digital channels through which to gain immediate access to a medical professional. Essentially, mobile devices and social networks have eliminated the problem of distance between urban areas, where many medical professionals are located, and remote regions, where there is a clear need for medical treatment and services.

This is according to health care service delivery company The Medical Concierge Group (TMCG), which has applied unified communications, underpinned by mobile technology and the internet, to bring patients into direct contact with those that can offer medical services. Based in Kampala, TMCG runs a call centre service that provides free access to doctors, pharmacists and other professionals, to anyone seeking consultation and information.

The call centre is set up using Asterisk software for the voice service and call centre technology E1 cards that enables the infrastructure to handle up to 60 simultaneous calls. RapidPro open source software is used for SMS engagement and, according to TMCG, can handle tens of thousands number of SMS interactions per minute. The data derived from all the call centre interactions is stored on servers that are hosted locally and backed up in the cloud.

While social networks, including WhatsApp and Facebook, remain the most popular first points of contact, the call centre services is geared for nationwide scale with the capacity to handle up to 8,000 voice calls per day, unlimited SMS messages and unlimited email, video chat and social media interactions.

"Surveys show that 60-70% of the reasons that take people to hospital do not actually require them to go to hospital physically. Most of them can be resolved remotely by a medical professional's interpretation, reassurance and direction. Mobile technology and medical call centres in particular provide an avenue through which a small team of health professionals can serve a larger number of people without physically being present," explains Dr Davis Musinguzi, MD at TMCG.

Dr Musinguzi says that with preventative medicine at the forefront of Uganda healthcare programs presently, the provision of adequate medical information that empowers individuals to take charge of their health is central.

TMCG's approach is on making several channels of communication available simultaneously to cater for the needs of potential users across various socio-economic strata.

The distinction is more centred on messaging (Messenger, Whatsapp, SMS, Twitter) versus Voice Calls (by mobile phone) vs video (for example Skype) and 70% of the engagement is via testing, and over 25% via voice calls and less than 1% for video, Dr Musinguzi adds.

"The more the richness of the media communication, the more effective ... video is more effective than messaging (with images and audio recording capabilities) which is more effective than voice calling only. The challenge is with the limit of bandwidth and cost of internet to entirely rely on video thus messaging is the preferred option," he continues.

"Over the last two years, we have noticed a growing trend with social messaging platforms becoming more popular and being used as the preferred mode of communication. They are very affordable to the users especially youths, allow more prolonged engagement and provide an avenue for adding multimedia like pictures and prescription notes," Dr Musinguzi continues.

TMCG points to several practical examples of how the technology platforms are making a difference to Uganda healthcare services, including emergency contraceptive advice, post-exposure prophylaxis for HIV, as well as chronic illnesses such as diabetes and hypertension.

Based on its own measurements and insight gained from data, TMCG says that the percentage of resolved health inquiries of users of the service currently stands at 98%, and the percentage reduction in the time spent accessing the same service through alternative/ traditional means is at 98% less time spent.

In addition to an increase in touchpoints for communication and public engagement, the percentage reduction in the cost of accessing the same service through alternative/traditional means is at 99% reduction in cost with an SMS at an average of 100 UGX SMS compared to 30,000 UGX consultation Fee, according to TMCG.

"There is also a 98% reduction in cost with mobile internet data at an average of 25 MB at 500 UGX compared to a 30,000 UGX consultation fee," adds Dr Musinguzi.TMCG has confirmed plans to officially launch its operation alongside local partners in Kenya and Nigeria in 2017

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